Correlation Analysis of the Characteristics of Spino-Pelvic Parameters and Health-Related Quality of Life After Long-Segment Fixation for Lenke-Silva Type 5 or 6 Degenerative Scoliosis.

Purpose: To retrospectively evaluate the characteristics of spino-pelvic parameters after long-segment fixation in patients with Lenke-Silva type 5 or 6 adult degenerative scoliosis and analyze the correlation between spino-pelvic parameters and health-related quality of life (HRQL).

Methods: Thirty-two patients with degenerative scoliosis underwent long-segment posterior fixation were included. The spino-pelvic parameters were evaluated after surgery, and the HRQL scores were determined using the Scoliosis Research Society-22 (SRS-22), Oswestry Disability Index (ODI), and visual analog scale (VAS). Linear regression was used to analyze the correlation between changes in spino-pelvic parameters and improvements in HRQL.

Results: Except for PI and TK, the other parameters showed significant differences after surgery (P < 0.05). All the scores of HRQL showed significant differences after surgery. The coefficient of correlation between ΔSVA and ΔVAS is 0.687 (P = 0.003), the coefficient of correlation between ΔSVA and ΔODI is 5.828 (P < 0.001). The coefficient of correlation between ΔLL and ΔVAS is -0.089 (P < 0.001), the coefficient of correlation between ΔLL and ΔODI is -1.553 (P = 0.003). The VAS score between the SVA ≥ 4cm and SVA < 4cm group have no significant difference, but have a significant difference in ODI. In PI-LL ≥ 20°and PI-LL < 20°group, the VAS and ODI all have a significant difference between the two groups.

Conclusion: SVA and LL have an important role in maintaining the overall balance of the spine and closely related to the postoperative HRQL, better HRQL may be achieved by reducing SVA and increasing LL. Good preoperative design will help achieve the best clinical efficacy.